Organization
SAFEWAY INC
Active
Other names
SAFEWAY PHARMACY #1988
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GIANNAKOPOULOS (ENROLLMENTS MANAGER)
(208) 395-3954
Entity
Organization
Contact information
Practice address
7177 E TANQUE VERDE RD, TUCSON, AZ 85715-3431
(520) 731-0147
(520) 731-0238
Mailing address
250 E PARKCENTER BLVD, BOISE, ID 83706-3940
(208) 395-6200
(623) 336-6896
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
Y006147
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1991135
PK
—
05
—
572629
—
AZ
Enumeration date
06/21/2006
Last updated
04/07/2020
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